The Health Care Blog – Page 995 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

The Talking Cure: moving patients to the center of care

Jun 17, 2008• 5

By Jane Sarasohn-Kahn

The relationship between patients and doctors is fundamentally changing. Transparency in medical records, patients’ accessibility to health information online, and online social media driving patient-to-patient conversations are some forces at the base of the future of health care.

This, according to a thought-provoking report that addresses the evolving nature of patients vis-à-vis physicians in the National Health Service (NHS) in the U.K. These factors are also driving change in health and health care in the U.S.

The Talking Cure: Why Conversation is the Future of Health Care is an essay published in mid-May 2008 by two smart guys at Demos. As the National Health Service in the U.K. approaches its 60th birthday, the Demos research organization launched The Healthy Conversations project (now known as The Talking Cure) to engage stakeholders in and outside of the NHS in a dialogue of how to move patients to the center of health in the U.K.

Grumpy doctors, but is it really worse now?

Jun 17, 2008• 13

By Matthew Holt

An essay in the NY times explains how terrible life is for doctors. Reimbursement is down, more time is spent arguing with managed care companies, there are more restrictions on the what they can prescribe, etc, etc.

Now I understand that primary care is in crisis, but overall physicians’ salaries in the last couple of years have gone up, and the first doc in the article is a cardiologist. Cardiologists, as this salary survey suggests, tend to make more than double what a primary care doc gets. And of course, fewer docs are primary care only now, and more are specialists (who make more money!). But whether or not physicians are getting paid less than they were, their perception surely is that that’s the case.

I am surprised that the burden of operating a practice and the demands of “managed care” are felt to have increased. Most observers would suggest that insurers have, since the days of Len Abramson & US Healthcare in the 1990s, backed off the extremes of medical micro-management. In fact, the most profitable health plan of recent years (Aetna) has bent over backwards to appear to be physician friendly. Whether or not it’s just window dressing is less certain.

If a doc living in the 1970s was forced into a 1990s world, I would understand the depression. And the surveys I was part of in the 90s indeed showed dismay at what was happening for them. But we’re now more than 10 years on from those times, and (as the politicians say) is it really worse now than it was four or five years ago?

Answers on a post-card (or at least in the comments), please!

Interest groups clash over doctor-owned specialty hospitals

Jun 17, 2008• 2

By Donald Johnson

Doctor-owned specialty hospitals deliver better quality of care, are more convenient for physicians and patients and take business away from not-for-profit and investor-owned general acute care hospitals, which have been trying to put them out of business for years.

The NY Times reports on the latest effort by liberal Democrats to take down the for-profit specialty hospitals. The Democrats behind this drive don’t believe in for-profit health care providers even though not-for-profit providers are as profit driven as the investor-owned providers. Most Republicans oppose the effort to restrict the growth of doctor-owned hospitals because they understand that many local hospital markets are dominated by a few institutions and that patients and insurance buyers need more competition among providers to keep costs under control.

This is a battle between the powerful American Medial Association, which supports doctor-owned hospitals, and the American Hospital Association, which represents mostly not-for-profit hospitals and wants to end competition from the doctor-owned specialty hospitals.

Trusera, out of beta & different enough to be interesting

Jun 17, 2008• 1

By Matthew Holt Trusera_copy

Keith Schorsch is a busy boy. Not only did he write a much commented piece about
Google Health and PHRs on this very station last week, but he also popped by last week to tell me about the new look for Trusera. Several of you saw Trusera launch at the Health 2.0 Conference last March. As of today they’ve removed the Beta tag, and have introduced a new look and new features.

The way Trusera is going about things is by collecting stories and journal entries, and then essentially parsing the keywords and text in those stories to connect people with others with similar situations. The distinction between this and most other social networking sites is that Trusera doesn’t have “forums
” or “channels” per se, but uses its search technology (somewhat inspired by Amazon where several of the founding team came from) to match lurkers and contributers with content and people relevant to them. There’s also some neat tools to help people build their stories with helpful suggestions appearing to the side as they’re being written — think of the Microsoft paper clip but done well! (At this stage it doesn’t take detailed self-reported patient clinical information a la PatientsLikeMe or PHRs).

So far there’s sizable activity on Trusera in autism, breast cancer and infertility, among other conditions. And of course Keith’s aim is to develop hundreds of thousands of members and millions of stories.

Trusera’s approach is different enough to be interesting as another option for community online. The technology is arguably better than others in the space, but as we know from other markets “better” technology doesn’t always mean most successful — as I tell many of my Mac using colleagues. But as was also pointed out to me this weekend, the vast majority of patients are not yet online in these communities. So it’ll be interesting as these numbers grow to see who will remain standing. Trusera clearly has a shot.

I always thought art galleries were a waste of space…

Jun 17, 2008

By Matthew Holt

until I saw this. Scroll down to the polka version of “A long way to the top.” Talk about a highway to hell!

JOB POST: PRODUCT MANAGER / Mayo Clinic

Jun 16, 2008• 1

Mayo

Mayo Clinic in Rochester, MN, has immediate openings for seasoned Product
Managers to support product development for Web and digital products aimed at consumers and employees.The product manager plays a key role in ensuring the strategic direction, design and on-time delivery of Mayo Clinic Health Solution’s online products including, MayoClinic.com, Mayo Clinic Health Assessment, Symptom Checker, Expert Blogs and other social/new media, and mobile applications.

State regulators challenge the rights to your DNA

Jun 16, 2008• 11

By Matthew Holt

It is something of a surprise that it popped up this way, but the establishment
challenge to Health 2.0 was going to start somewhere. And it appears to have started with two big states, New York & California ordering 13 companies to stop Gene Testing.

Karen Nickel, from the California Department of Public Health, argues that these companies are “operating without a clinical laboratory license in California. The genetic tests have not been validated for clinical utility and accuracy.”

But as those companies are outsourcing the testing anyway, that argument barely holds water. Here’s what Navigenics CEO Mari Baker said “Navigenics uses a doctor to transit orders and review results, and it relies on a state-certified lab testing company to do the gene tests.”

So what this really is about, of course, is who has the right to order a test? Is it you or do you have to go through a doctor? Or put another way, is it your DNA or is it the state’s?

Stats Can’t Explain Everything; The Anecdote Remains Relevant

Jun 16, 2008• 3

By MAGGIE MAHAR

Lately, I’ve been thinking about the difference between stories and stats — those hard and fast numbers that give us “objective” information about everything from the body politic to the human body.

Social scientists like data, perhaps because it makes social science seem more “scientific.” They like to square things off and measure them. They like to count: How many? How much? What do the polls say? Percentages are impressive.

Try to tell a story, however, and a purist will remind you that “the plural of data is not anecdote.”

But what some social scientists (and some physicians) forget is that statistics measure only what can be counted. Many of the things that are most important, in medicine as in life, are immeasurable. Stories are valuable because they can capture some of the messiness of reality, including the ambiguities and contradictions that make both human experience and the human mind/body just beyond comprehension. (Since we have only the mind with which to understand the mind, ultimately investigation must end in a stand-off.)

What do Johnny Cash and employer-based health care have in common?

Jun 16, 2008• 2

By Robert Laszewski

OK, maybe it’s a stretch but bear with me.

I heard a senior exec from a big health plan say the other day that it’s hard to believe we will ever see the end of health insurance distributed primarily through the workplace in favor of an individual-based health insurance system. In fact, much of the health insurance industry is lining up behind staying with the system we know best and the one who has been our customer all these years–the employer.

That is understandable. As someone who came up through the ranks looking at the employer as the customer and individual health insurance as a minor product subset I have the same reaction.

But I will tell you that this idea of moving away from third-party employer pay and to a system of individual responsibility — or moving from defined benefit health insurance to defined contribution health insurance — has been coming on us for some time now.

Health costs are small businesses’ No. 1 problem

Jun 15, 2008• 3

By Jane Sarasohn-Kahn

The cost of health insurance is the No. 1 problem cited by small business owners. Health costs beat gas prices — the No. 2 most severe problem cited by small business, in a March 2008 survey.

This week, small business leaders convened at the annual National Small Business Summit conference of the National Federation of Independent Business (NFIB).

The report notes the downturn in the economy during the second half of 2007 when the NFIB Small Business Optimism Index dropped to 94.6 in December, the lowest since 2001.